CQC report explained · a nursing home
What the CQC found at Brabourne Care Centre
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Medicines were not always managed safely. Some risk guidance was unclear, although there were enough staff, safeguarding arrangements, infection controls and emergency evacuation plans.
- Effective?
- Good
- This area was not inspected during this focused visit. The previous comprehensive inspection rating was used in calculating the overall rating.
- Caring?
- Good
- This area was not inspected during this focused visit. The previous comprehensive inspection rating was used in calculating the overall rating.
- Responsive?
- Good
- This area was not inspected during this focused visit. The previous comprehensive inspection rating was used in calculating the overall rating.
- Well-led?
- Requires improvement
- Management checks and audits did not identify or address problems with medicines and care plans. There was a positive culture, but leadership and improvement systems were inconsistent.
What inspectors found, January 2022
Brabourne Care Centre is rated Requires Improvement; inspectors found unsafe medicines management and checks that did not identify important problems.
This was an unannounced focused inspection on 02 December 2021. Inspectors looked only at Safe and Well-led after concerns about care quality and staffing. They spoke with people, relatives and staff, and checked care, medicines, staff and management records.
The home was not always safe. Medicines records and stock counts did not match, pain patches were not recorded clearly, and creams were not always dated when opened. Some care records did not give staff enough guidance about risks such as skin damage or seizures.
The home had enough staff during the inspection, used agency staff when needed, and people said they felt safe. Staff were kind and worked with healthcare professionals. However, audits did not find the medicines and care planning problems. The overall rating fell from Good at the previous inspection to Requires Improvement.
Enough staff
Inspectors found enough staff to meet people's needs and keep them safe. Agency staff were used when needed.
“There were sufficient numbers of staff deployed to meet people's needs and keep people safe.” from the report
Kind interactions
Inspectors saw caring interactions between staff and people. People, relatives and staff also described a positive culture.
“We observed kind caring interactions between people and staff, who showed genuine fondness to one another.” from the report
Joined-up healthcare
Staff worked with outside healthcare professionals to support people's needs.
“Staff worked with a number of healthcare professionals including dieticians, speech and language therapists and the GP to ensure people's needs were met.” from the report
Medicines records and stock
seriousMedicine counts did not match the electronic records. The report also found problems with recording pain patch positions and dating creams.
“We completed a reconciliation of medicines and found that the medicine count did not match the stock on the electronic MAR.” from the report
Unclear risk guidance
needs fixingSome care records did not clearly tell staff what action to take to reduce risks, including skin damage and choking.
“Risk assessments and care plans we reviewed did not contain the guidance needed to inform staff on action to take, for example if a person was to choke.” from the report
Audits missed problems
needs fixingThe home's checks and audits did not identify the medicines and care planning issues found by inspectors.
“Staff and the registered manager completed a wide range of checks and audits on the service; however, these failed to identify and address the issues we highlighted during inspection.” from the report
- 01How have you checked that medicine stock now matches the electronic medicine records?
- 02How do staff record the position and movement of pain relief patches?
- 03How are creams and ointments dated when they are opened?
- 04Which high-risk care plans and risk assessments have been reviewed first, and what guidance do they now give staff?
- 05What extra medicines checks and staff retraining have been introduced since the inspection?
This was a focused inspection of Safe and Well-led only; the other ratings were carried over from the previous comprehensive inspection. This explanation was written from the published report of 12 January 2022 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, August 2018
Rated Good; inspectors found safe, kind and responsive care, with some short-stay evacuation plans and food feedback needing attention.
The inspection was unannounced and took place on 4 and 5 July 2018. Inspectors spoke with people, relatives and staff, observed care and activities, checked the building, and reviewed care plans, medicines, staffing and other records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found medicines were managed safely, staffing levels were enough, staff were trained, and people were supported to access healthcare and make choices.
The inspection also found clear improvements since April 2017, when the service was rated Requires Improvement and had three legal breaches. Those previous breaches had been met. However, some evacuation plans for people staying short term were not yet detailed enough, and inspectors recommended a better way of gathering feedback about meals.
Safe medicines and staffing
Medicines were stored, administered and recorded safely. Inspectors found enough nurses and care staff to meet people's needs during the inspection.
“Medicines were managed safely and there were enough nurses and care staff on duty.” from the report
Personalised care
Care plans included people's preferences, routines, health needs and important personal information. Staff knew people well and supported them in their preferred way.
“They also contained more person-centred detail.” from the report
Kind and respectful staff
People were treated with kindness and compassion. Staff respected privacy and dignity, explained what they were doing and checked that people were comfortable.
“Staff treated people with kindness and compassion.” from the report
Activities and relationships
People could take part in group and individual activities, use the garden and continue hobbies. Staff also supported contact with family, friends and the wider community.
“People were offered the opportunity to pursue their hobbies and interests and to enjoy taking part in a range of social activities.” from the report
Improved management checks
The home had improved its audits and oversight since the previous inspection. Management monitored incidents and took action to reduce the risk of them happening again.
“Quality assurance audits were carried out to identify any shortfalls within the service and how the service could improve.” from the report
Short-stay evacuation plans
needs fixingSome people staying for a short period did not have enough clear information in their personal emergency evacuation plans. The manager said these plans would be reviewed, and inspectors said this needed ongoing improvement.
“PEEP's for some people who were staying for a short period of time did not always contain sufficient clear guidance.” from the report
Mixed views about meals
minorPeople gave mixed feedback about the taste and quality of the food. Inspectors recommended introducing a system to gather people's views about meals.
“We recommend the provider introduces a system for seeking feedback from people about the quality of meals served.” from the report
- 01How do you make sure personal emergency evacuation plans are complete for people who are staying short term?
- 02What system do you now use to collect and act on residents' views about the quality and choice of meals?
- 03How often are care plans and risk assessments reviewed when a person's needs change?
- 04How do you check that staffing levels remain sufficient when people's needs change?
- 05What changes were made after the previous inspection's requirement notices?
This was an unannounced inspection of the whole care home, including the premises and care provided, and it assessed all five CQC questions. This explanation was written from the published report of 29 August 2018 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Brabourne Care Centre
4 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.
- January 2022Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- August 2018Goodup from Requires improvementSafe: GoodWell-led: Good
- July 2017Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- March 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2014
Report published without a new overall rating.
- March 2014
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- February 2012
Report published without a new overall rating.
- February 2011
Registered with the Care Quality Commission on 4 February 2011.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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